Provider Demographics
NPI:1538387576
Name:HAYES, CONNIE LEE (LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:LEE
Last Name:HAYES
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 SELWYN AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3323
Mailing Address - Country:US
Mailing Address - Phone:704-617-4439
Mailing Address - Fax:704-523-1878
Practice Address - Street 1:1373 E MOREHEAD ST STE 12
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2900
Practice Address - Country:US
Practice Address - Phone:704-617-4439
Practice Address - Fax:704-523-1878
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3192101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor